Nutritional risk and therapy for severe and critical COVID-19 patients: A multicenter retrospective observational study.

OBJECTIVE: To evaluate the nutritional risk and therapy in severe and critical patients with COVID-19. METHODS: A total of 523 patients enrolled from four hospitals in Wuhan, China. The inclusion time was from January 2, 2020 to February 15. Clinical characteristics and laboratory values were obtained from electronic medical records, nursing records, and related examinations. RESULTS: Of these patients, 211 (40.3%) were admitted to the ICU and 115 deaths (22.0%). Patients admitted to the ICU had lower BMI and plasma protein levels. The median Nutrition risk in critically ill (NUTRIC) score of 211 patients in the ICU was 5 (4, 6) and Nutritional Risk Screening (NRS) score was 5 (3, 6). The ratio of parenteral nutrition (PN) therapy in non-survivors was greater than that in survivors, and the time to start nutrition therapy was later than that in survivors. The NUTRIC score can independently predict the risk of death in the hospital (OR = 1.197, 95%CI: 1.091-1.445, p = 0.006) and high NRS score patients have a higher risk of poor outcome in the ICU (OR = 1.880, 95%CI: 1.151-3.070, p = 0.012). After adjusted age and sex, for each standard deviation increase in BMI, the risk of in-hospital death was reduced by 13% (HR = 0.871, 95%CI: 0.795-0.955, p = 0.003), and the risk of ICU transfer was reduced by 7% (HR = 0.932, 95%CI:0.885-0.981, p = 0.007). The in-hospital survival time of patients with albumin level ≤35 g/L was significantly decreased (15.9 d, 95% CI: 13.7-16.3, vs 24.2 d, 95% CI: 22.3-29.7, p < 0.001). CONCLUSION: Severe and critical patients with COVID-19 have a high risk of malnutrition. Low BMI and protein levels were significantly associated with adverse events. Early nutritional risk screening and therapy for patients with COVID-19 are necessary.

Uric acid as a prognostic factor and critical marker of COVID-19.

The purpose of this study is to explore whether uric acid (UA) can independently act as a prognostic factor and critical marker of the 2019 novel corona virus disease (COVID-19). A multicenter, retrospective, and observational study including 540 patients with confirmed COVID-19 was carried out at four designated hospitals in Wuhan. Demographic, clinical, laboratory data were collected and analyzed. The primary end point was in-hospital death of patients with COVID-19. The concentration of admission UA (adUA) and the lowest concentration of uric acid during hospitalization (lowUA) in the dead patients were significantly lower than those in the survivors. Multivariate logistic regression analysis showed the concentration of lowUA (OR 0.986, 95% CI 0.980-0.992, p < 0.001) was able to independently predict the risk of in-hospital death. The mean survival time in the low-level group of lowUA was significantly lower than other groups. When lowUA was ≤ 166 µmol/L, the sensitivity and specificity in predicting hospital short-term mortality were 76.9%, (95% CI 68.5-85.1%) and 74.9% (95% CI 70.3-78.9%). This retrospective study determined that the lowest concentration of UA during hospitalization can be used as a prognostic indicator and a marker of disease severity in severe patients with COVID-19.

[Microsatellite analysis of genetic diversity and phylogenetic relationship of nine species of grouper in genus Epinephelus].

Thirteen microsatellite markers of Epinephelus awoara previously discovered by our lab were selected to analyze the genetic diversity and phylogenetic relationship of nine species of grouper (E. awoara, E. merra, E. fario, E. fasciatus, E. lanceolatus, E. akaara, E. septemfasciatus, E. coioides and E. fuscoguttatus) from South China Sea. The results showed that the number of total alleles of these 13 microsatellite loci was 84 in these fishes, the mean number of alleles ranged from 2.69 to 5.38, mean polymorphism information content (PIC) ranged from 0.1976 to 0.4267, mean observed heterozygosity (Ho) from 0.4615 to 0.6239, mean expected heterozygosity (He) from 0.3510 to 0.4754 and mean Hardy-Weinberg departure value (D) from 0.1097 to 0.2836, respectively. All of these indicated that genetic diversity of the nine species of grouper was at a medium level. Two NJ dendrograms showed that E. coioides, E. fuscoguttatus and E. lanceolatus were grouped together, while E. awoara, E. akaara and E. septemfasciatus were in a second group, and E. merra, E. fasciatus and E. fario were in a third group which had a relatively closed relationship with the second group. The dendrograms could also support a conclusion that Promicrops lanceolatus (E. lanceolatus) should be included in genus Epinephelus.